"Conversations" is a series of brief interviews, features and stories where UNODC Regional Office for South Asia (ROSA) records the views and experiences of those people who have been pivotal in contributing to the field of drug abuse and treatment, human trafficking, HIV AIDS and prison reform. The purpose of this journal is to carry the socially relevant messages of these individuals and organisations, in the wake of drug use and crime becoming a global reality, to people who can not only join  in this fight, but most importantly to get these messages to those to whom it will matter most.

The first topic in this series is an insightful and inspiring interview with Dr. Shanthi Ranganathan who founded and developed in South India, Chennai, a nationally influential centre, The T T Ranganathan Clinical Research Foundation or "TTK Hospital" to respond to alcohol and drug problems. Gradually over the years, TTK Hospital has emerged as a pioneer in this field, strengthening its skill to deal with alcohol and drug issues by keeping abreast with latest treatments. What lends her work a unique dimension and authority is her determination of giving a new life to thousands of individuals affected by addiction and rebuilding their broken families with compassion and unconditional support.

Shanthi Ranganathan (SR): Coming from a family where tradition was important to one's cultural and social identity, no one in my family drank. While growing up, drinking alcohol was an offence punishable under the law in Tamil Nadu. Liquor shops and bars were scarce. By the time I graduated, drinking was a common phenomenon. After I married, I noticed that alcohol was served to guests while entertaining them. My husband too drank and his relation with alcohol started at a young age. Inevitably, he became an alcoholic. Fighting this battle of addiction alone, he would stop drinking for short period of times and relapse into the habit. At that point in time, we learnt that treatment for this was available in the United States and took him there for treatment. He was admitted in a centre for one month and I had the chance to attend a few sessions for family members. That was the first time when I realized that addiction to alcohol was not a lost cause and was a treatable condition. My husband died when he was hardly 33 years old. Along with him I too had suffered seeing someone you love slowly slip away. I observed that there was no centre available in India. I decided to do something constructive about it and founded with the help of my supportive in-laws TT Ranganathan Clinical Research Foundation with funding from the companies owned by our family.

UR: How did you then start this foundation?

SR: It was a modest beginning, a small step. We started the centre in our own ancestral bungalow near the Santhome beach. But before starting to provide my services formally, I wanted to be trained in this field. I went to 'Hazeldon' an organisation in the United States, for training. After returning, I started offering help through an out-patient programme. I was still not satisfied with the way I was providing the therapy. So I went to Broadway Lodge in England, which was started by Hazeldon. I stayed there for a period of one month trying to understand how to conduct group therapy and deal with issues during counseling sessions. I gained better clarity. This improved my skills and confidence.

UR: What is the vision or mission of TTK Hospital?

SR:The Foundation had its beginning in 1980 as a day care center for treating alcoholics. In 1985, the therapeutic services were extended to drug dependent persons as well. In 1987, the TTK Hospital was established with a 65 bed treatment and rehabilitation center offering a month-long residential programme. The vision of TTK hospital is to provide quality service with utmost dedication and commitment; sharing skills, knowledge and expertise and thereby equipping professionals to spread the concept of care and creating awareness so that more and more people make the right choices reducing the number of drug users. The aim is that the positive social change has to be felt at the family, peer and community level.

UR: How is your foundation associated with UNODC?

SR: T T Ranganathan Clinical Research Foundation has been designated as one of the International Network of Treatment and Rehabilitation Resource Centers by the UNODC, Vienna. Our association with UNODC has been instrumental in reaching out to resource centers at national and international levels. This fosters partnership increasing effective and wider outreach of messages on alcohol and drug addiction positively impacting people who need help. In phase 1, the Foundation had to identify potential resource centers, undertake capacity building and training of trainers (ToTs) at resource centers and support working groups of resource centers in different regions to synthesize best practices on community based treatment and drug treatment and rehabilitation in prison setting to name a few.

Under the project H13 - we undertook peer led intervention. We also mentored two NGOs in Southern India. We have also developed four manuals for UNODC i.e. Drug addiction -Identification and initial motivation, Counseling for drug addiction - Individual, family and group, Documentation for addiction management - assessment, client profiling, recording and evaluation, Drugs abuse and HIV/AIDS - concerns of family members. We have also been designated as the Regional Learning Centre for Low Cost Care for IV drug users. Working with UNODC gives us a lot of exposure to best practices available in South Asian countries. Our biggest contribution for Ministry of Social Justice and Empowerment, was developing the ' Minimum Standards of Care' which prescribes guidelines to ensure therapeutic services and standardized recording and documentation procedures. It has helped to improve the quality of services of the NGOs.

UR: What were some of the challenges you faced when you started this hospital? Given that Tamil Nadu is largely conservative when it comes to openly discussing about alcohol and drug abuse, did you feel people hesitating to come to you for help or treatment?

SR: You are right. People would not freely approach the hospital and ask for help. We can only talk about the help the hospital can provide but the patients have to reach out to us. They would feel embarrassed and often ashamed to admit that they were alcohol or drug addicts. There is stigma associated with alcohol or drugs in Indian societies. The challenge was in changing the perception of the community towards people who suffer from drug and alcohol abuse and who are in the process stigmatized. To change the perception of the community, families of the victim also have to be sensitized to this problem. The issue is complex and interrelated. Families strongly objected to participate in the "mandatory family programme". They did not see why it was important to be part of a programme when they don't even consume alcohol or drugs.
The second challenge was convincing the alcohol and drug victims and other health centers to have faith in us. Why would they trust a lady who has no medical background? They preferred to seek help from conventional health centers even if they may not be equipped to deal with their problems.

UR: Can you share with us one success, among the many, that has been instrumental in genuinely helping victims of alcohol and drug abuse?

SR: For me, the Alcoholics Anonymous meetings have been very successful in helping alcohol and drug victims to recover. Fellowship of men and women who have recovered from alcohol or drug addiction motivate members to abstain from alcohol. Because of the feeling of kinship and belonging, patients easily relate to AA members. They feel they can easily reach out for help to people who will not judge them since they too have undergone similar life experiences. Interestingly, I have observed that what AA meetings achieve is more impacting than individual sessions spent with Psychiatrists. A one to one level of treatment can be alienating or discouraging making the fight for recovery a real struggle. In a group with similar people, the man feels part of a team and as a result is more motivated to fight his addiction problem. The road to recovery is less painful when you have company.

What is your message to policymakers and what is your vision for the future?
There should be an effort to develop a National Alcohol and Drug Policy. I would also like to add that the Government of India (GoI) aided by organisations like UNODC should initiate prevention programmes at a national level incorporating life skills. This will result in youngsters making sensible choices.